Investig Magn Reson Imaging.  2021 Dec;25(4):323-331. 10.13104/imri.2021.25.4.323.

Diagnostic Criteria of T1-Weighted Imaging for Detecting Intraplaque Hemorrhage of Vertebrobasilar Artery Based on Simultaneous Non-Contrast Angiography and Intraplaque Hemorrhage Imaging

• Lim S
• Kim NH
• Kwak HS
• Hwang SB
• Chung GH

• KMID: 2526485
• DOI: http://doi.org/10.13104/imri.2021.25.4.323

Abstract

Purpose
To investigate the diagnostic criteria of T1-weighted imaging (T1W) and time-of-flight (TOF) imaging for detecting intraplaque hemorrhage (IPH) of a vertebrobasilar artery (VBA) compared with simultaneous non-contrast angiography and intraplaque hemorrhage (SNAP) imaging.
Materials and Methods
Eighty-seven patients with VBA atherosclerosis who underwent high resolution MR imaging for evaluation of VBA plaque were reviewed. The presence and location of VBA plaque and IPH on SNAP were determined. The signal intensity (SI) of the VBA plaque on T1W and TOF imaging was manually measured and the SI ratio against adjacent muscles was calculated. The receiveroperating characteristic (ROC) curve was used to compare the diagnostic accuracy for detecting VBA IPH.
Results
Of 87 patients, 67 had IPH and 20 had no IPH on SNAP. The SI ratio between VBA IPH and temporalis muscle on T1W was significantly higher than that in the noIPH group (235.9 ± 16.8 vs. 120.0 ± 5.1, P < 0.001). The SI ratio between IPH and temporalis muscle on TOF was also significantly higher than that in the no-IPH group (236.8 ± 13.3 vs. 112.8 ± 7.4, P < 0.001). Diagnostic efficacies of SI ratios on TOF and TIW were excellent (AUC: 0.976 on TOF and 0.964 on T1W; cutoff value: 136.7% for TOF imaging and 135.1% for T1W imaging).
Conclusion
Compared with SNAP, cutoff levels of the SI ratio between VBA plaque and temporalis muscle on T1W and TOF imaging for detecting IPH were approximately 1.35 times.

Keyword

Intracranial artery; Atherosclerosis; Intraplaque hemorrhage; Magnetic resonance imaging